Displaying publications 1 - 20 of 251 in total

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  1. Lee LK, Chen PC, Lee KK, Kaur J
    Ann Acad Med Singap, 2007 Mar;36(3):169-74.
    PMID: 17450261
    INTRODUCTION: The aim of this study was to determine the prevalence of violence-related behaviours among adolescents and the factors associated with it.

    MATERIAL AND METHODS: This was a cross-sectional school survey conducted on 4500 adolescent students, using a structured questionnaire. Data were collected using the supervised self-administered questionnaire [a modified version of the Youth Risk Behavior Surveillance in the Malaysian National Language (Bahasa Malaysia)].

    RESULTS: Our study showed that 27.9% of students had been involved in a physical fight, 6.6% had been injured in a fight, 5.9% had carried a weapon, 7.2% had felt unsafe, 18.5% had had their money stolen and 55.0% had had their property stolen. Adolescents who carried weapons to school, smoked, used drugs, felt sad or hopeless and played truant were more likely to be involved in physical fights after adjusting for age, sex, and ethnicity.

    CONCLUSION: Violence-related behaviours among adolescents, especially involvement in physical fights, are common and are positively associated with certain factors such as smoking, taking drugs, playing truant, feeling sad or hopeless. Interventions designed at targeting adolescent violence should also address these factors and target the high-risk groups. There may be a need to identify and provide services for adolescents who exhibit these factors.

  2. Abdullah MF, Nor NM, Mohd Ali SZ, Ismail Bukhary NB, Amat A, Latif LA, et al.
    Ann Acad Med Singap, 2011 Apr;40(4):168-78.
    PMID: 21678002
    INTRODUCTION: Diabetes mellitus (DM) is a chronic disease that is prevalent in many countries. The prevalence of DM is on the rise, and its complications pose a heavy burden on the healthcare systems and on the patients' quality of life worldwide.

    MATERIALS AND METHODS: This is a multicentre, cross-sectional study involving 5 Health Clinics conducted by Family Medicine Specialists in Malaysia. Convenience sampling of 100 respondents with DM were selected. The International Classifi cation of Functioning, Disability and Health (ICF) based measures were collected using the Comprehensive Core Set for DM. SF-36 and self-administered forms and comorbidity questionnaire (SCQ) were also used.

    RESULTS: Ninety-seven percent had Type 2 DM and 3% had Type 1 DM. The mean period of having DM was 6 years. Body functions related to physical health including exercise tolerance (b455), general physical endurance (b4550), aerobic capacity (b4551) and fatiguability (b4552) were the most affected. For body structures, the structure of pancreas (s550) was the most affected. In the ICF component of activities and participation, limitation in sports (d9201) was the highest most affected followed by driving (d475), intimate relationships (d770), handling stress and other psychological demands (d240) and moving around (d455). Only 7% (e355 and e450) in the environmental category were documented as being a relevant factor by more than 90% of the patients.

    CONCLUSION: The content validity of the comprehensive ICF Core set DM for Malaysian population were identified and the results show that physical and mental functioning were impaired in contrast to what the respondents perceived as leading healthy lifestyles.

  3. Ng ML, Tan TT, Roslan BA, Rajna A, Khalid BA
    Ann Acad Med Singap, 1993 Jul;22(4):569-72.
    PMID: 7504901
    We evaluated the usefulness of sensitive thyrotrophin hormone (TSH) measurements in determining the thyroid status in the follow-up of Graves' patients undergoing medical treatment with thionamides. Out of a total of 186 serum samples tested, TSH levels were suppressed in 123 (66.1%), normal in 32 (17.2%) and elevated in 31 (16.7%) cases. Total T4, or T3 or both were elevated only in 97 (74.8%) cases of TSH-suppressed patients, indicating that TSH is less discriminatory as a first-line test for patients under treatment due to the hypothalamic-pituitary lag period. No comparisons with free T4 or free T3 were done in this study. Both total T4 (120 +/- 28 nmol/l) and TBII (23 +/- 21%) levels were significantly greater (p < 0.02) in the euthyroid group with suppressed TSH. This may suggest that persistence of a thyrotoxic state may still be present.
  4. Razak IA, Ali MM
    Ann Acad Med Singap, 1989 Sep;18(5):516-8.
    PMID: 2619242
    The present study analysed the records of 342 elderly subjects aged 55 years and above of different ethnic groups to ascertain the types and level of their unperceived dental needs. The overall percentage of unperceived needs was highest among the Malays (96.1% or 74/77 subjects) and among the men (88.5% or 139/157 subjects). The unperceived need for prosthetic treatment was highest among the Malays and Chinese as well as among women, whereas the unperceived need for treatment for periodontal disease was highest among the Indians. The data for unperceived needs for prosthetic treatment as well as for treatment for caries and periodontal disease were somewhat similar among men. Within each ethnic group, variations among sex in the unperceived needs for the various dental symptoms were also noticeable. Further research is indicated to ascertain the role of traditional and cultural concepts and dogmas in determining the importance attached to the various dental health symptoms within each ethnic group.
  5. Joseph VT, Fong PH
    Ann Acad Med Singap, 1981 Oct;10(4):502-6.
    PMID: 6124206
    Two hundred and twelve of undescended testes were operated on in the Department of Surgery, Singapore General Hospital between the years 1974 through 1980. There was a 51.9% incidence of right undescended testis, 34.9% left undescended testis and 13.2% were bilateral. The method of treatment was surgical exploration with orchidopexy wherever technically feasible or orchidectomy if the testis was found to be severely hypoplastic. Of the total series, 42% were operated on before the age of 5 years. The oldest patient undergoing orchidopery was aged 40. Failure of orchidopexy to secure the scrotal position for the testis was noted in 14 cases. This was probably due to inadequate mobilisation at the first operation. There was no mortality and no significant morbidity following surgical treatment in this series.
  6. Suleiman AB, Musa Z, Morad Z
    Ann Acad Med Singap, 1988 Jul;17(3):454-6.
    PMID: 3064705
    Ten out of 237 patients who underwent renal transplantation between 1975 and October 1986 developed tuberculosis. Most patients presented with vague symptoms, and typical symptoms commonly associated with tuberculosis were not common. Six had positive urine cultures. One patient had positive sputum and urine cultures and one had positive sputum and cerebrospinal fluid cultures for tuberculosis. In this last patient cryptococcus was also cultured from the sputum and CSF. Nine of the 10 patients responded well to antituberculosis therapy and was cured of the infection. The patient with associated cryptococcal infection died 2 months after presentation. Side effects of antituberculous therapy was minimal and easily resolved on stopping the offending drug.
  7. Neoh YL, Neoh PF, Salleh A, Yusof ZB, Gurusamy B, Ahmad Tajudin LS
    Ann Acad Med Singap, 2018 06;47(6):226-229.
    PMID: 30019068
  8. Koh CK, Hew FL, Chiu CL
    Ann Acad Med Singap, 2000 Jul;29(4):528-30.
    PMID: 11056786
    INTRODUCTION: The association of chronic urticaria and thyroid autoimmunity is not well recognised and the potential use of thyroxine in the treatment of chronic urticaria in patients with thyroid autoimmunity is even less well known.

    CLINICAL PICTURE: We report a case of chronic urticaria in an euthyroid patient with evidence of significantly elevated levels of thyroglobulin and microsomal antibodies.

    TREATMENT AND OUTCOME: Treatment with thyroxine has brought about clinical remission of the chronic urticaria but no change in the thyroid antibody levels could be demonstrated.

    CONCLUSION: Patients with chronic urticaria should be screened for evidence of thyroid autoimmunity. A closely monitored trial of thyroxine therapy for those who have thyroid autoimmunity can be rewarding.

  9. Loh HH, Kamaruddin NA
    Ann Acad Med Singap, 2020 Jul;49(7):468-476.
    PMID: 33000110
    During Ramadan, Muslims fast from sunrise (Sahur) to sunset (Iftar) and are required to abstain from food and fluids, including oral and injectable medications. Patients with diabetes who fast during Ramadan are at risk of developing hyperglycemia with increased risk of ketoacidosis, hypoglycemia, dehydration and thrombosis. Pre-Ramadan education and preparation of a fasting patient are essential to reduce severe complications. This review paper summarizes studies to date on oral and injectable medications available for patients with type 2 diabetes during Ramadan fasting, as well as recommendations on management of these patients during Ramadan. Although there is limited data on the use of Metformin, Acarbose and Thiazolidinedione in Ramadan, they appear to be safe. Sulphonylurea, especially Glibenclamide, is associated with higher risk of hypoglycemia during Ramadan fasting, hence may need adjustment in dosing and timing. The incretin group and SGLT2 inhibitor use during Ramadan fasting is associated with low risk of hypoglycemia with no increased adverse events. Insulin regimes need to be individualized for patients who fast during Ramadan.
  10. Goh KH, Ng ML, Roslan BA, Tan TT, Nasri BN, Khalid BA
    Ann Acad Med Singap, 1993 Jul;22(4):539-43.
    PMID: 8257054
    Serum concentrations of thyroid stimulating hormone (TSH) and thyroid autoantibodies in pregnant patients with thyroid disease at various stages of pregnancy were determined by in-house ELISAs. In normal pregnancy, serum TSH levels were significantly elevated (p < 0.05) from 13 weeks of gestation. The normal reference ranges for TSH for the second (0.6-5.0 mIU/l) and third trimester (0.6-5.6 mIU/l) were significantly higher (p < 0.05; p < 0.01 respectively) compared to 0.4-4.5 mIU/l for the first trimester. In pregnant thyroid patients, serum TSH levels correlated highly (p < 0.001) to T4 (r = 0.740), FT4I (r = 0.683) and MicAb (microsomal antibodies) (r = 0.825) but weaker (p < 0.01) to T3 (r = -0.512), FT3I (r = 0.520) and TgAb (thyroglobulin antibodies) (r = 0.618). Thus, measurement of TSH with the highly sensitive ELISA (enzyme linked immunosorbent assay) would form a useful first line test for thyroid dysfunction in pregnancy while measurement of thyroid autoantibodies would aid in the diagnosis of autoimmune hypothyroidism.
  11. Ali O, Tan TT, Sakinah O, Khalid BA, Wu LL, Wan Nazaimoon WM, et al.
    Ann Acad Med Singap, 1994 Nov;23(6):852-5.
    PMID: 7741498
    Thyroid function and pubertal development of aborigines (Orang Asli) and Malays at different socioeconomic strata were assessed among 1136 subjects aged 7 years and above. Anthropometric measurements, goitre and pubertal staging were done. Serum thyroxine (T4), triiodothyronine (T3) and growth hormone were measured using radioimmunoassays (RIA) and serum thyroid stimulating hormone (TSH) by immunoradiometric assays (IRMA). It was found that serum T3 in children was significantly higher in Malays from rural areas, girls and children aged less than 13 years. However, in adults, T3 was significantly associated with anthropometric indices. On the contrary, serum T4 levels were higher among children from urban areas. In adults, serum T4 levels were significantly related to nutritional status and they increased according to the levels of social development, being lowest in remote areas and highest in urban areas. However, serum TSH levels were significantly higher in Orang Asli at all ages and among malnourished children. By using multiple regression, apart from age, gender and ethnicity, nutritional status was a significant predictor for T3 levels in children and adults. Presence of goitre was an important factor which determined the T4 levels in children and adults after controlling for other factors. It was also a predictor for TSH levels in children but not in adults. Fasting serum growth hormone (GH) levels were significantly higher among less privileged groups and decreased according to social development. Serum growth hormone was negatively correlated with anthropometric indices and had a significant association with malnutrition.(ABSTRACT TRUNCATED AT 250 WORDS)
  12. Khalid BA, Ng ML
    Ann Acad Med Singap, 1991 Mar;20(2):273-6.
    PMID: 1883189
    Thyroid eye disease is autoimmune in nature and associated with Graves' Disease. Autoantibodies to the 64 kDa antigen in thyroid membranes cross-react to the 64 kDa proteins in human eye muscle membranes. Antibody dependent cell mediated cytotoxicity against eye muscle cells are also found in patients with thyroid eye disease. The purpose of this paper is to review the treatment available and to share the authors' experience using cyclosporin A. In the majority of cases, thyroid eye disease is mild, manifest only as bilateral or unilateral proptosis, with/without grittiness of the eyes. This is usually treated conservatively with eye drops. If proptosis is more severe and there is incomplete closure of eyelids, epiphora and conjunctival injection, then lateral tarrsorrhaphy is usually effective, combined with use of eye pads and eye drops. The problem of diplopia can be treated conservatively with special lenses, or with surgical correction of tethered muscles. However when proptosis is severe, with raised intraocular pressure, severe chemosis and danger of blindness, then the choice of therapy is controversial: rapid decompression by surgical means or use of high doses of prednisolone. Most prefer prednisolone therapy initially, surgical decompression if it fails. Various other methods have been tried, aimed at the immunological nature of the disease, namely plasmapheresis, radiotherapy and immunosuppressive drugs such as cyclosporin, with variable success. Our experience with cyclosporin had been mixed and inconclusive.
  13. Ch'ng SL, Chandrasekharan N
    Ann Acad Med Singap, 1985 Apr;14(2):223-8.
    PMID: 4037680
    The pattern of plasma and urine sugar changes after 50g glucose load in 1900 Malaysians (522 males and 1378 females) consisting predominantly of Malays, Chinese and Indians were studied. The data were analysed using Statistical Package for Social Sciences (SPSS). The results show bimodal distribution of 120 min. plasma sugar values in the age groups 21 years and above and trimodal distribution in most groups above 40 years. The mean 120 minutes plasma sugar cut-off values for nondiabetics (ND), impaired glucose tolerance (IGT), and diabetics (DM) of 8.4 and 11.1 mmol/l respectively were close to the values recommended by the National Diabetic Data Group (NDDG). Fifty two percent of all subjects showed peaked plasma sugar values at 60 minutes (14% of them had IGT, 12% DM), 25% peaked at 30 minutes (98% of them were ND). The rest showed peaked values at 90 minutes (17%), 120 minutes (4%) and 150 minutes (2%) and from this group forty two percent were DM and 23% had IGT. Reliance on urine sugar qualitative tests could misclassify 7.3% of subjects (predominantly elderly females) with hyperglycaemia of greater than 11 mmol/l. This study shows that in the 50 g glucose tolerance test, the NDDG criteria for ND, IGT, DM is still applicable to the Malaysian population. The sampling time could be reduced to four points at 0, 60, 90, and 120 minutes. Blood analysis is the preferred method for the diagnosis of hyperglycaemia in elderly females.
  14. Meah FA, Abdullah T, Jasmi AY, Hisham AN, Tan TT, Khalid BA, et al.
    Ann Acad Med Singap, 1996 Mar;25(2):251-4.
    PMID: 8799016
    Between January 1978 to December 1993, 130 cases of adrenal diseases were diagnosed and surgically treated at the National University of Malaysia. They were 58 cases (44.6%) of Conn's syndrome, 40 cases (30.7%) of Cushing's syndrome, 20 cases (15.3%) of phaeochromocytoma and 12 cases (9.2%) of adrenocortical carcinoma (ACC). The commonest cause of Conn's syndrome was an adenoma (96.5%) which affected the left gland four times more than the right gland. Cushing's syndrome was caused by adrenocortical adenoma (32.5%), diffuse bilateral adrenal hyperplasia (40.0%), pigmented macronodular hyperplasia (20.0%) and adrenal carcinoma (7.5%). Twenty-five percent of the phaeochromocytomas were extraadrenal in origin arising mainly from the abdominal sympathetic chain. More than 50% of ACCs were non-functioning tumours. Fifty percent of the patients with ACC had inoperable tumours. The prognosis was poor even with adjuvant chemoradiotherapy. The main surgical approach was the anterior transabdominal route. There was no operative mortality or morbidity in all operated cases.
  15. Ismail NM, Mustapha MS, Megat R
    Ann Acad Med Singap, 1997 Nov;26(6):754-7.
    PMID: 9522974
    The aim of this study was to investigate if colloidal bismuth subcitrate (CBS) can penetrate the gastric mucus barrier to reach the different sites of the antral mucosa and to estimate the time course for CBS to reach and remain in the mucosa. A single dose of CBS was administered orally to rats that were sacrificed at different time intervals post treatment. The control group received gum acacia without CBS. Colloidal bismuth subcitrate, visualised as electron dense precipitate (EDP), was seen in the gastric mucus layer, intercellular spaces and intracellularly after 30 minutes and disappeared after 6 hours. Scant amounts of EDP were observed in the gastric crypts, confined only to the upper parts of these structures. We concluded that CBS can penetrate the mucus and has a wide but uneven distribution in the gastric mucosa. Colloidal bismuth subcitrate, in the concentration given only penetrated the upper two-thirds of gastric pits and not the lower one-third. We also concluded that CBS has to be given 6 hourly to ensure its continuous presence in the gastric mucosa.
  16. Lim EW, Meers PD
    Ann Acad Med Singap, 1989 Jul;18(4):348-51.
    PMID: 2679337
    A rapid method of assay, using a monoclonal antibody linked to alkaline phosphatase, was used for the detection of the Pontiac subgroup of Legionella pneumophila serogroup 1. It was tested for its specificity against 53 strains of Legionella recently isolated from the environment in Singapore and Malaysia. The specificity and sensitivity of this method of assay was confirmed, though there is some concern that the specificity was too narrow, and there are reservations about the criteria suggested for interpreting the results.
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